1 FLEET lANDING (NURSING FACILITY) SERVICE UPGRADE 2015 �J } CITY OF ATLANTIC BEACH
t 800 SEMINOLE ROAD
J ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ELEC-724
Job Type: ELECTRIC ONLY
Description: switches lighting upgrade service
Estimated Value:
Issue Date: 3/27/2015
Expiration Date: 9/23/2015
PROPERTY ADDRESS:
Address: 1 FLEET LANDING BLVD
RE Number: 169397-0200
PROPERTY OWNER:
Name: NAVAL CONTINUING CARE
Address: 1 FLEET LANDING BLVD 1 FLEET LANDING BOULEVARD
GENERAL CONTRACTOR INFORMATION:
Name: COASTAL ELECTRIC COMPANY
Address: 2759 ST JOHN BLUFF RD
Phone: - -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
New Commercial Electrical $1,050.00
Lighting Outlets, Including Fixtures $732.60
Trade Permit Base Fee $55.00
Total Payments: $1,841.60
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph(904) 2/47-5826 Fax (904) 247-5845
JOB ADDRESS: / Ff eef Llol t0� NUN> PERMIT#
A-la,4',L 8earl, . r- 32,13
JEA INFORMATION REQUIRED ON ALL PERMITS a�0 AMPS 2-08 VOLTS 3 PHASE
VALUE OF WORK$ l 7� Jiay
NEW SERVICE ❑ Overhead ❑ Underground ❑T Underground up Pole
Residential(Main) Service
7:0-100 amps 101-150amps El151-200amps ❑ amps #of Meters
Commercial(Main)Service
—L.0-100 amps ❑101-150amps ❑151-200amps ❑ amps —_CT Service amps
Conductor Type Size
Multi-Family(Main)Service
—1 0-100 amps C 101-150amps ❑151-200amps ❑ amps #of Unit Meters
--Temporary Pole amps
SERVICE UPGRADE _71—amps XCT Service loau amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps ❑200amps ❑ amps ❑CT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: __q!t7_0-30amps 31-100amps 101-200amps
Appliances: 1_0-30amps 31-100amps 101-200amps
A/C Circuits: __55 _0-60amps 61-100amps
Heat Circuits: # circuits @ k
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
Swimming Pool ❑ Sign [I Smoke Detectors_Qty ❑'Transformers
KVA [I Motors hp
FIRE ALARM SYSTEM,04equires 3 sets of plans) — �!a r VALUE OF WORK$
Qty / s amps /ZD
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection []Panel Change OH to UG
Other:
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. I hereby certify that I have
read this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether
specified or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of
construction.
Property Owners Name (CACC , AIS"I �o�� n i ng
Phone Number
Electrical Company
Coa.Srl_1 54cr r C C" Office Phone goy 94 S-yo16 Fax 61f.5--4166
Co. Address: 275q �s �� J S City V a� StateFt Zi. y 6
License Holder (Print): Slaftch r I State Certification/Registration# Fro w4 r3
Notarized Signature of License Holder
JESSICABRIONES Sworn and subsc ' ed before me this da of Ur 20��
Notary Public,state of FlorWe
Ry Comm Expim April 17,2M8 Signature of Notary Public
Commis w No.FF 110641 g